Just Wait to Pre-oxygenate!

I believe sometimes we are in rush for no reason. Patient with hypoxia and no reserve requires some oxygen to prevent hypoxia during intubation, DSI vs RSI. I am fan of DSI to buy some time to see how we could assist with oxygenation before definitive airway intervention.

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Are we done with CT/LP to rule out SAH?

The BMJ study was a shocking news in 2011 regarding Sensitivity of Modern CT scan in diagnosis of SAH within 6 hours of presentation, Click here for more Then, Storke in 2012 reported another study that showed there is “no added value of CSF analysis to detect SAH within 6 hours of patient presentation with […]

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How to handle a Laryngoscope!

It is interesting that you teach a concept and try to back it up with some literature, but sometimes you do not have a simple tools to show it. Canadian Journal of Anesthesia published an article Laryngoscope manipulation by experienced versus novice laryngoscopists in December 2014. This is exactly what I’m talking about! how to […]

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Single Dose Antibiotic before ED Discharge!

This is a very routine practice in ED, “I’ll be more comfortable to give one dose of Abx and then send him/her home” I did not know where this quote came from. I searched Pubmed and found this article: Antibiotic use in the emergency department. IV: Single-dose therapy and parenteral-loading dose therapy. J Emerg Medicine […]

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Epinephrine in OHCA!

We discussed 2 studies in our class specific session on impact of EPi on out of hospital cardiac arrest. J Am Coll Cardiol published another study  this month and challenged again use of Epi in OHCA. 1,556 patients from 2000 to 2012, using EPi with different doses, and the conclusion is  pre-hospital use of epinephrine […]

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Cavity Lesion

Very nice mnemonic for Cavity lesion DDx in cxray: Cavity, C: Cancer or Mets, A: autoimmune; granulomas from, V: vascular (both bland and septic pulmonary embolus), I: infection(TB, fungall), T: trama (pneumatocoeles), Y: youth (congenital pulmonary airways malformation) Reference  

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aVR: The most Ignored Lead

JACC in 2001 published an article that nicely explained the necessity of interpreting lead aVR in clinical setting. There are 3 categorizes that we should consider in this regard:1. acute coronary syndromes, 2. acute PE, 3. arrhythmia. I strongly recommend you to take a look to the following link JACC article

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CONTRAST CT or NON CON CT?

That is the question: contrast CT or non contrast CT?   it is very difficult sometimes to answer, but for some facts such as r/o of appy, divericulitis and other pathologies, why do we need  Contrast CT? as an emergency physician, it is a matter of 2-4 hours of delayed disposition and increased LOS, more cost, more […]

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Hypertension treatment

What is your favorite hypertension numbers to treat in ED? there are a lots of controversies regarding the exact number to start treatment in ED but recent Cochrane review on mild HTN suggest that antihypertensive agents used in the treatment of adults with hypertension stage I (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg)

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SYNCOPE vs Near SYNCOPE

I read this article long time ago but I had a discussion with one of my resident and to give her reference I would like to have it here. Basically this study showed that Syncope and Near syncope has same critical interventions or adverse outcomes. This term should be taking care as we care about […]

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Low Back Pain

Very detail and informative article regarding Low Back Pain. I believe this article should be read by patients and physicians, and physicians can summarize this for their patients. This is not new but still covers EBM by NEJM. Link to article

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Normalization of Vital Signs Does Not Reduce the Probability of Acute Pulmonary Embolism

Jeffry Kline is famous for his research on PE and his latest article in Academic Journal of Emergency Medicine(Jan 2012) is opening another window to PE regarding Normalization of Vital Signs Does Not Reduce the Probability of Acute Pulmonary Embolismin Symptomatic Emergency Department Patients.

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Effective Antibiotic Treatment Prescribed by Emergency Physicians in Severe Sepsis or Septic Shock

Journal of Emergency Medicine published an article with title of “Effective Antibiotic Treatment Prescribed by Emergency Physicians in Patients Admitted to the Intensive Care Unit With Severe Sepsis or Septic Shock” in Dec,2011.

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